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Pediatr Crit Care Med. 2010 Jan;11(1):139-41. doi: 10.1097/PCC.0b013e3181ae7834.

Pediatric cardiac arrest refractory to advanced life support: is there a role for terlipressin?

Author information

1
Pediatric Intensive Care Unit, Hospital de Cruces, Barakaldo, Bizkaia, Spain.

Abstract

OBJECTIVE:

Pediatric cardiac arrest unresponsive to advanced life support and several adrenaline doses has a very poor prognosis. Alternative vasopressors could improve the results of resuscitation in such cases. We report our experience with the compassionate administration of terlipressin in children who suffered in-pediatric intensive care unit cardiac arrest and did not respond to immediate advanced life support and at least three epinephrine doses.

DESIGN:

Prospective multicenter registry.

SETTING:

Three pediatric intensive care units at university-affiliated tertiary care children's hospitals.

PATIENTS:

Five pediatric patients, aged 5 mos to 12 yrs, with in-pediatric intensive care unit cardiac arrest unresponsive to advanced life support that included at least three epinephrine doses.

INTERVENTIONS:

Addition of terlipressin (10-20 microg/kg intravenous, up to two doses) to standard cardiopulmonary resuscitation.

MEASUREMENTS AND MAIN RESULTS:

Sustained return of spontaneous circulation was achieved in four cases, two of them were declared dead 6 and 12 hrs later, and the remaining two survived without cardiopulmonary procedures-related sequelae and with good neurologic condition.

CONCLUSIONS:

Terlipressin might contribute to obtain sustained return of spontaneous circulation in children with refractory in-hospital cardiac arrest. A randomized controlled clinical trial should be conducted to investigate the optimal drug treatment in pediatric cardiac arrest.

PMID:
19581820
DOI:
10.1097/PCC.0b013e3181ae7834
[Indexed for MEDLINE]

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